ESRD True or False?

Jul 22, 2008

  1. MedSuppPro
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    MedSuppPro Guru

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    Is this a true statement/disclaimer?


    I was given an example of the costs of a chronic condition of Rena Failure requiring dialysis treatments, and that it was explained to me that this particular disease would lock me into a Medicare Advantage Plan, should I enroll in one. If I were to develop End Stage Renal Disease (ESRD), I understand that I would not be able to move from plan to plan on an annual basis.
     
  2. jdeasy
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    There is a more detailed explanation, but, the short answer is yes.

    If a person has an MA plan and then develops ESRD, the plan will not kick them out. They would still have the AEP and OEP periods, but, no other MA would take them with ESRD nor would any med sup.

    Many people seem to believe that an SEP will granted for everyone with a GI period to enroll in a med sup. when the MA plans blow up. That is not a done deal, but, it's a good guess.

    If the person is in an MA for the first time and is within the 12 month window, they would have the option of original medicare and a med sup. Lot of "if"s in that equasion.

    Again, the short answer is that they are stuck where they are. There could be many mitigating factors, though, that would give them more options.
     
    jdeasy, Jul 22, 2008
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  3. Dave020
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    Dave020 Super Moderator Moderator

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    Even under this circumstance, wouldn't ESRD eliminate the ability to make that move back to traditional supplement since there is no GI for ESRD? Just asking. Since they can't buy the med sup at all.
     
    Dave020, Jul 22, 2008
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  4. jdeasy
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    Could be. Is there no GI for ESRD on a med sup? Even on a T-65 person? My med sup carrier in Ky says to not ask any medical questions or even if they smoke during the GI period.

    I haven't run across an ESRD person trying to get a med sup, but, if I had, I would not have put it on the app.

    I better do some research on that now that you brought it up.


    There are some SNP plan for folks with ESRD in parts of the country. I don't have one available here.
     
    jdeasy, Jul 22, 2008
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  5. Dave020
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    Dave020 Super Moderator Moderator

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    I have moved out of the senior arena, but seem to recall that all of the CA applications always asked about ESRD somewhere on the application with the caveat that those with ERSD, pre-, t- or post-65 were ineligible to buy it.
     
    Dave020, Jul 22, 2008
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  6. mcleanbr
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    mcleanbr Super Genius

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    The ESRD question is for MA qualification. I have signed up T-65 on Med. Supp. with ESRD. In GA, Evercare has a ESRD MA SNP program that they sell direct.
     
    mcleanbr, Jul 22, 2008
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